• 중환자간호학회지
• /
• 제3권2호
• /
• pp.1-11
• /
• 2010

Purpose: This study was designed to identify the factors affecting healing of Stage 2 pressure ulcer in an acute care facility in Korea. Methods: 286 Stage 2 pressure ulcers of 145 patients were examined. Data were collected in the period between October $1^{st}$, 2006 and September $30^{th}$, 2007. Data were analyzed with Kaplan-Meier survival analysis for cumulative recovery rate of Stage 2 pressure ulcers. Cox proportional hazard model was used to examine effects of multiple variables simultaneously. Results: Out of 286 initial Stage 2 pressure ulcers, 204 (71.3%) pressure ulcers healed completely. The median time to heal was 15 days according to Kaplan-Meier survival analysis. Cox proportional hazard model showed that the Stage 2 pressure ulcers healed more quickly when pressure redistribution surfaces were used (p<.001, HR=2.184), patients were administered with vitamins (p= .038, HR=1.451), and the size of the pressure ulcers were small (${\leq}3.0cm^2$, p= .006, HR=1.765). Conclusion: The factors contributing to the healing of Stage 2 pressure ulcer in an acute care setting were the application of pressure redistribution surface, small ulcer size (${\leq}3.0cm^2$), and the administration of vitamins.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제17권1호
• /
• pp.15-22
• /
• 2011

Nowadays, a proportion of healthcare service for the elderly has been improved due to the factors, such as a prolonged life expectancy, a growth of aging population and a change of member of family. For these factors, it is necessary for the elderly to receive treatment for multidisciplinary diseases, associated with psychological care of sociological concept. It is quite difficult in an acute-care hospital to accommodate the elderly patient because of the fact that an acute-care hospital is required to maintain a high level of medical care and technical standard. That is why specialized medical service is needed for the elderly. In the case of Germany, they are at the stage of the change from large scale facilities to specialized facilities applying the integrated concept. This paper addresses the medical environmental factor and distinction of medical facilities for the elderly through survey and analysis relating to all change in Germany. Therefore, it aims to suggest a fundamental resource for architectural planning and network of medical facilities for the elderly.

• 중환자간호학회지
• /
• 제14권3호
• /
• pp.73-86
• /
• 2021

Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

• 웰빙융합연구
• /
• 제7권1호
• /
• pp.51-65
• /
• 2024

Purpose: This study is to propose the establishment and direction of a public health-medical cooperation system for rehabilitation medical services for people with physical and brain disabilities in Gangneung, Korea. Research design, data and methodology: The study focused on 30 individuals with these disabilities registered. Data was collected from December 20, 2021, to December 31, 2021, through structured surveys administered by researchers visiting disability-related facilities, utilizing convenience and random sampling methods. Descriptive statistics and cross-analysis were applied for analysis. Results: Specifically, among respondents with physical disabilities, a total of 20 needs were identified, with 'Visiting health services' (25.0%) and 'Oral health services' (20.0%) ranking highest. The survey results regarding visit-based rehabilitation services for disability support showed a high demand, emphasizing the necessity of service provision tailored to the needs of recipients, focusing on disability prevention, health management, and motor function recovery, rather than solely medical or therapeutic concepts. Conclusions: Gangwon National University Hospital, as the regional referral hospital in Gangwon, should collaborate with Gangwon Province Rehabilitation Hospital to provide prompt acute rehabilitation services. Moreover, cooperation and collaboration with Gangneung Asan Hospital, the tertiary hospital in the region, are essential to ensure continued acute and recovery phase rehabilitation therapy for a certain period in the Gangneung area.

• Journal of Preventive Medicine and Public Health
• /
• 제11권1호
• /
• pp.41-48
• /
• 1978

To examine the result of the government Medical Aid Program which began in January, 1977 as a part of social security policy implementation, all the medical records of the clients and official statistics in the year were analysed. The specific objectives this study pursues include the magnitudes and patterns of morbidity and utilization, and the characteristics of clients. One Korean rural area, Koje county was selected as the study area and subsequently all the clinics and hospitals assigned to work out the Aid Program are the subjects for the survey. A brief summary of the sutdy results as follows: a. The clients of Koje county are 6.4% of the total population in the area, more than the average percentage of the clients in Korea. It reflects on low level of economic status of the residents of the area. b. The population structure of the clients indicates that the large proportions of young and old age group are overwhelming, while the middle age group share very small portions. c. The utilization rates for primary care are 2.0 persons, 11.6 visits and 22.6 treatment days per 100 persons per months. Annual hospitalization is rated as 13.7 cases and 164 days per 1,000 persons, The utilization rates are slightly lower than those expected rates during planning period but eventually become higher than those of general population in rural Korea. d. The factors which influence the utilization rates are identified with client group (low income vs indigent), age and sex. e. The utilization pattern for primary care demonstrates seasonal variation similar to the pattern of general rural population in the low income group, but none in the indigent group. f. The most common diseases revealed at the primary care clinics are the acute respiratory infection (26.9%), acute gastritis (10.8%), skin and subcutaneous infection (6.8%). The cases of acute conditions are outnumbered than the cases of chronic condition. 8. The clinics, hospitals and other related health institutions are well cooperated in dealing health care services in their own capacities. Considering the above results Medical Aid Program generated satisfactory results at least in the utilization aspect.

• Journal of Preventive Medicine and Public Health
• /
• 제38권3호
• /
• pp.276-282
• /
• 2005

Objectives : To evaluate the predictive validity of three scoring systems; the acute physiology and chronic health evaluation(APACHE) III, simplified acute physiology score(SAPS) II, and mortality probability model(MPM) II systems in critically ill patients. Methods : A concurrent and retrospective study conducted by collecting data on consecutive patients admitted to the intensive care unit(ICU) including surgical, medical and coronary care unit between January 1, 2004, and March 31, 2004. Data were collected on 348 patients consecutively admitted to the ICU(aged 16 years or older, no transfer, ICU stay at least 8 hours). Three models were analyzed using logistic regression. Discrimination was assessed using receiver operating characteristic(ROC) curves, sensitivity, specificity, and correct classification rate. Calibration was assessed using the Lemeshow-Hosmer goodness of fit H-statistic. Results : For the APACHE III, SAPS II and MPM II systems, the area under the receiver operating characterist ic(ROC) curves were 0.981, 0.978, and 0.941 respectively. With a predicted risk of 0.5, the sensitivities for the APACHE III, SAPS II, and MPM II systems were 81.1, 79.2 and 71.7%, the specificities 98.3, 98.6, and 98.3%, and the correct classification rates 95.7, 95.7, and 94.3%, respectively. The SAPS II and APACHE III systems showed good calibrations(chi-squared H=2.5838 p=0.9577 for SAPS II, and chi-squared H=4.3761 p=0.8217 for APACHE III). Conclusions : The APACHE III and SAPS II systems have excellent powers of mortality prediction, and calibration, and can be useful tools for the quality assessment of intensive care units(ICUs).

• 한국간호교육학회지
• /
• 제15권2호
• /
• pp.274-284
• /
• 2009

Purpose: This study surveyed how victims with acute traumatic hand injuries received pre-hospital care and how satisfied they were with that care. Method: A total of 100 adults were interviewed using a questionnaire at one microsurgical clinic in Korea. Results: Only 12 patients (12.0%) were transported by the ambulance and the others by private or company's vehicles. Only 9 patients (9.0 %) were able to get appropriate first response from the EMTs or industrial health providers at the scene of the accidents. The mean time required for transportation from the scene of the accident to the operation room of the microsurgical clinic was $372.65{\pm}719.17$ minutes. Most of the patients were satisfied with the pre-hospital care provided by the EMT or industrial health providers but dissatisfied with that provided by lay persons. Conclusion: This study demonstrates that there is a lack in the first response provided at the scene and the activation of EMS (Emergency Medical System) for acute hand injury. It is necessary to educate the public about the appropriate first response and rapid transportation to the appropriate microsurgical clinic.

• 한국간호교육학회지
• /
• 제23권1호
• /
• pp.95-107
• /
• 2017

Purpose: The aim of this study was to assess the efficacy of web-based simulation and high-fidelity simulation on acute heart disease patient care. Methods: The project used a comparative study design with two simulation-based training modalities. A total of 144 nursing students participated in this study: 76 students in a web-based simulation, and 68 students in a high-fidelity simulation. Participants rated their self-efficacy, problem-solving ability, interest in learning, level of stress, satisfaction with the simulation experience, and level of difficulty of the simulation. Results: The scores for self-efficacy, problem-solving ability, and interest in learning including interest in clinical training in the high-fidelity simulation group was higher than in the web-based simulation group. However, there were no significant differences in interest in learning, including interest in nursing knowledge, and in lab training, level of stress, satisfaction with the simulation experience, and level of difficulty of the simulation. Conclusion: A high-fidelity simulation of acute heart disease patient care might be beneficial to developing many more abilities for nursing students than would a web-based simulation. Also, since the web-based simulation improved interest in nursing knowledge, it could be a viable alternative to high-fidelity simulation. Further study is needed to verify the effects of varied levels of simulation-based care with more rigorous outcomes.

• Tuberculosis and Respiratory Diseases
• /
• 제82권1호
• /
• pp.53-61
• /
• 2019

Background: Antiphospholipid antibody syndrome (APS), an important cause of acquired thrombophilia, is diagnosed when vascular thrombosis or pregnancy morbidity occurs with persistently positive antiphospholipid antibodies (aPL). APS is a risk factor for unprovoked recurrence of pulmonary embolism (PE). Performing laboratory testing for aPL after a first unprovoked acute PE is controversial. We investigated if a specific phenotype existed in patients with unprovoked with acute PE, suggesting the need to evaluate them for APS. Methods: We retrospectively reviewed patients with PE and APS (n=24) and those with unprovoked PE with aPL negative (n=44), evaluated 2006-2016 at the Asan Medical Center. We compared patient demographics, clinical manifestations, laboratory findings, and radiological findings between the groups. Results: On multivariate logistic regression analysis, two models of independent risk factors for APS-PE were suggested. Model I included hemoptysis (odds ratio [OR], 12.897; 95% confidence interval [CI], 1.025-162.343), low PE severity index (OR, 0.948; 95% CI, 0.917-0.979), and activated partial thromboplastin time (aPTT; OR, 1.166; 95% CI, 1.040-1.307). Model II included age (OR, 0.930; 95% CI, 0.893-0.969) and aPTT (OR, 1.104; 95% CI, 1.000-1.217). Conclusion: We conclude that patients with first unprovoked PE with hemoptysis and are age <40; have a low pulmonary embolism severity index, especially in risk class I-II; and/or prolonged aPTT (above 75th percentile of the reference interval), should be suspected of having APS, and undergo laboratory testing for aPL.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• 제16권4호
• /
• pp.219-224
• /
• 2013

Acute abdominal pain is a common complaint in childhood, and it can be caused by a wide range of underlying surgical and non-surgical conditions. The most common non-surgical condition is gastroenteritis, while the most common surgical condition is appendicitis. Abdominal pain in children varies with age, associated symptoms, and pain location. Although acute abdominal pain is usually benign and self-limiting, there are uncommon but life-threatening conditions that require urgent care. Meticulous history taking and physical examinations are essential to determine the cause of acute abdominal pain and to identify children with surgical conditions such as appendicitis.